Propofol as an Induction Agent for Endotracheal Intubation Can Cause Significant Arterial Hypotension in Preterm Neonates

2011 ◽  
Vol 55 (3) ◽  
pp. 140
Author(s):  
&NA;
Keyword(s):  
Endotracheal Intubation ◽  
Arterial Hypotension ◽  
Preterm Neonates ◽  
Induction Agent

scholarly journals Propofol as an induction agent for endotracheal intubation can cause significant arterial hypotension in preterm neonates

2010 ◽  
Vol 20 (7) ◽  
pp. 605-611 ◽  
Author(s):  
LARS WELZING ◽  
ANGELA KRIBS ◽  
FRANK EIFINGER ◽  
CHRISTOPH HUENSELER ◽  
ANDRE OBERTHUER ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Arterial Hypotension ◽  
Preterm Neonates ◽  
Induction Agent

scholarly journals Intravenous dexmedetomidine 1µg/kg as premedication to attenuate hemodynamic response to laryngoscopy and endotracheal intubation in surgeries under general anesthesia

2017 ◽  
Vol 4 (6) ◽  
pp. 1884
Author(s):  
Dixitkumar B. Modh ◽  
Pratiti Gohil ◽  
Manthan Parmar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Induction Agent ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Dose Requirement ◽  
Hemodynamic Stability ◽  
Induction Dose

Background: Choice of premedication and hemodynamic stability are always remain important concerns during laryngoscopy and endotracheal intubation for Anesthesiologists. Dexmedetomidine offers anxiolytic, sedation, hypnosis, analgesia, antisialagogue action as well as sympatholysis which make most suitable drug as premedication. Our aims for this study to evaluate efficacy of Injection Dexmedetomidine 1µg/kg intravenously as premedication on attenuation of hemodynamic changes to laryngoscopy and intubation as well as requirement of injection Propofol as an induction agent.Methods: In Present study, 60 patients of ASA I, II of age 18 to 45 years were randomly divided in to two groups of 30 each. In group NS, 10 ml normal saline and in group D1 injection Dexmedetomidine 1µg/kg diluted in 10 ml of normal saline was used. In both groups study solutions administered over 10 minutes. Both the groups were administered standard general anaesthesia and requirement of Propofol was noted as an induction agent. Heart rate, blood pressure (systolic, diastolic and mean arterial pressure) were compared at baseline, 2 min, 5 min, 10 minutes (SD2, SD5, SD10) after study drugs administration, before induction (BI), after induction (AI), 1 minute (T1), 2 minutes (T2), 5 minutes (T5) and 10 minutes (T10) after laryngoscopy and intubation in both groups.Results: HR, SBP, DBP and MAP highly significantly reduced at 2 min, 5 min and 10 minutes after infusion of Dexmedetomidine in group D1 as compared to group NS. (P<0.01). After induction values are highly significant in group D1 than group NS from baseline (P<0.01). Highly significant mean rise in hemodynamic parameters (HR, SBP, DBP and MAP) from baseline were observed in group NS compared to group D1 after laryngoscopy and intubation (P<0.01). Induction dose requirement of inj. Propofol significantly reduced in group D1 compared to other group (P<0.01).Conclusions: Injection Dexmedetomidine 1µg/kg provides effective and complete attenuation of pressure response to laryngoscopy and endotracheal intubation as premedication with decreased requirement of inj. Propofol for induction without any side effects.

Safety of Propofol as an Induction Agent for Urgent Endotracheal Intubation in the Medical Intensive Care Unit

2014 ◽  
Vol 30 (8) ◽  
pp. 499-504 ◽  
Author(s):  
Seth J. Koenig ◽  
Viera Lakticova ◽  
Mangala Narasimhan ◽  
Peter Doelken ◽  
Paul H. Mayo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Intubation ◽  
Medical Intensive Care Unit ◽  
Induction Agent ◽  
Medical Intensive Care

Premedication for Endotracheal Intubation in the Neonate

2018 ◽  
Vol 37 (4) ◽  
pp. 238-247
Author(s):  
Christopher McPherson
Keyword(s):  
Adverse Effects ◽  
Endotracheal Intubation ◽  
Muscle Relaxant ◽  
Neonatal Intensive Care ◽  
Safety Data ◽  
Pharmacokinetic Profile ◽  
Preterm Neonates ◽  
Pharmacokinetic Data ◽  
Common Procedure ◽  
Duration Of Action

Endotracheal intubation, a common procedure in neonatal intensive care, results in distress and disturbs physiologic homeostasis in the newborn. Analgesics, sedatives, vagolytics, and/or muscle relaxants have the potential to blunt these adverse effects, reduce the duration of the procedure, and minimize the number of attempts necessary to intubate the neonate. The medical care team must understand efficacy, safety, and pharmacokinetic data for individual medications to select the optimal cocktail for each clinical situation. Although many units utilize morphine for analgesia, remifentanil has a superior pharmacokinetic profile and efficacy data. Because of hypotensive effects in preterm neonates, sedation with midazolam should be restricted to near-term and term neonates. A vagolytic, generally atropine, blunts bradycardia induced by vagal stimulation. A muscle relaxant improves procedural success when utilized by experienced practitioners; succinylcholine has an optimal pharmacokinetic profile, but potentially concerning adverse effects; rocuronium may be the agent of choice based on more robust safety data despite a relatively prolonged duration of action. In the absence of an absolute contraindication, neonates should receive analgesia with consideration of sedation, a vagolytic, and a muscle relaxant before endotracheal intubation. Neonatal units must develop protocols for premedication and optimize logistics to ensure safe and timely administration of appropriate agents.

Adverse Events in Failed First-Pass Intubation vs. Successful First-Pass Intubation in the Emergency Department - An Analytical Hospital-Based Study

2021 ◽  
Vol 8 (06) ◽  
pp. 283-287
Author(s):  
Devendra Prasad KJ ◽  
Biju Shekar
Keyword(s):  
Emergency Department ◽  
Adverse Events ◽  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Tertiary Care ◽  
Induction Agent ◽  
Care Hospital ◽  
Cross Sectional ◽  
First Pass ◽  
Life Threatening

BACKGROUND First-pass success is the successful intubation on the first attempt. It is the desired goal of emergency intubation and failure to achieve it may increase the risk of adverse effects. With failure of first pass intubation, life-threatening complications occur, commonly in critically ill patients. The aim of this study is to determine the association between the success of first-pass intubation and frequency of adverse events during endotracheal intubation. METHODS A cross sectional analytical study was done in a tertiary care hospital between October 2016 and October 2017. 100 failed first-pass intubation cases and 100 successful first-pass intubation cases were evaluated for factors associated with failed first-pass intubation and frequency of adverse events following intubation. RESULTS The groups were matched with respect to gender, induction agent use, fentanyl use and type of laryngoscope used. Mean age in failed first-pass intubation group was 5.61 years higher than subjects in successful first-pass intubation group (P = 0.016). Proportion of subjects with difficult airway was 19 % in failed first-pass intubation group and 3 % in successful first-pass intubation (P < 0.001). Failed first-pass intubation cases had higher frequency of adverse events like oesophageal intubation (9 % vs. 0 %), aspiration (7 % vs. 1 %), cuff leakage (2 % vs. 0 %) and hypotension (7 % vs. 1 %) compared to successful first-pass intubation cases. CONCLUSIONS The frequency of adverse events was high in failed first-pass intubation. Older age and presence of difficult airway were factors significantly associated with failed first-pass intubation. KEYWORDS First Pass Intubation, First-Pass Success, Adverse Events, Emergency Department, Failed First Attempt, Endotracheal Intubation

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